Hepatectomia laparoscópica com portal único: experiência pioneira no Brasil

Machado, Marcel Autran; Surjan, Rodrigo C.; Makdissi, Fábio F.

doi:10.1590/s0102-67202013000200016

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…We have tried some systems for laparoscopic cholecystectomies and we had difficulties in triangulation, exposure and retraction and did not find any advantage over conventional laparoscopy. We believe that this new system may offer a better platform for single-incision surgery reducing learning curve for skill acquisition (10) . our initial experience with single port distal pancreatectomy showed no exposure or triangulation difficulties and operative time was not superior to our other laparoscopic cases.…”

Section: Discussionmentioning

confidence: 97%

First Single-Port Laparoscopic Pancreatectomy in Brazil

Machado¹,

Surjan²,

Makdissi³

2013

Arq. Gastroenterol.

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-Context -Pancreatic surgery is an extremely challenging field, and the management of pancreatic diseases continues to evolve. in the past decade, minimal access surgery is moving towards minimizing the surgical trauma by reducing numbers and size of the port. in the last few years, a novel technique with a single-incision laparoscopic approach has been described for several laparoscopic procedures. Objectives -We present a single-port laparoscopic spleen-preserving distal pancreatectomy. To our knowledge, this is the first single-port pancreatic resection in Brazil and latin America. Methods -A 33-year-old woman with neuroendocrine tumor underwent spleen-preserving distal pancreatectomy via single-port approach. A single-incision advanced access platform with gelatin cap, self-retaining sleeve and wound protector was used. Results -operative time was 174 minutes. Blood loss was minimal, and the patient did not receive a transfusion. The recovery was uneventful, and the patient was discharged on postoperative day 4. Conclusions -Single-port laparoscopic spleen-preserving distal pancreatectomy is feasible and can be safely performed in specialized centers by skilled laparoscopic surgeons. HEADINGS -Pancreatectomy. laparoscopy.

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Section: Discussionmentioning

confidence: 97%

First Single-Port Laparoscopic Pancreatectomy in Brazil

Machado¹,

Surjan²,

Makdissi³

2013

Arq. Gastroenterol.

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“…It is especially used in young female due to the good cosmetic results. Single-incision laparoscopic procedure is less invasive than standard multiport laparoscopy but may have unique difficulties for the laparoscopic surgeon 12 , 13 . First, retraction is significantly limited.…”

Section: Discussionmentioning

confidence: 99%

“…In the last few years, a novel technique with a single-incision laparoscopic approach has been described 3 . This technique has mainly been used for laparoscopic cholecystectomy, but recent reports showed feasibility even in more complex operations such as gastric, liver and pancreas resection 12 , 13 , 19 .…”

Section: Introductionmentioning

confidence: 99%

Single-port for laparoscopic gastric resection with a novel platform

Machado

Makdissi

Surjan

2014

ABCD, arq. bras. cir. dig.

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IntroductionLaparoscopic gastrointestinal resections using single-port are possible, but triangulation problems and the need of articulated instruments difficult the procedures.AimTo present a surgical alternative using single-port laparoscopic device on gastric resection.TechniqueThe patient is placed in a supine and reverse Trendelenburg position with surgeon between patient's legs. First assistant was on the right side of the patient with the monitor placed on the patient's cranial side. With the patient under general anesthesia, a transumbilical 3 cm skin incision is performed. A single-incision advanced access platform with gelatin cap, self-retaining sleeve and wound protector is introduced through this incision. Three 5-12 mm operating ports were introduced through the single-port device. Due to the gel cap and sleeves, no articulated instruments are necessary. CO2 pneumoperitoneum is established at 12 mmHg. A rigid 30 degree 10 mm laparoscope is introduced. Operation begins with access to the lesser sac by opening the omentum along the greater curvature of the stomach using harmonic scalpel. Once the stomach is fully exposed and a stay suture is place around the tumor. Gastric wall is divided with cautery 1 cm away from the tumor. Tumor is excised. Gastric wall is sutured with two-layer running suture. No drain was used. Umbilical incision was closed.ResultsThis procedure was used in one patient with gastric duplication. Operative time was 200 minutes. Blood loss was minimal. Recovery was uneventful and patient discharged on postoperative day 2. Final aspect of the umbilical incision was good.ConclusionsGastric resection with single-port laparoscopic platform is feasible and may be safely performed in selected patients.

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Review of Pure Endoscopic Full-Thickness Resection of the Upper Gastrointestinal Tract

et al. 2015

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Natural-orifice transluminal endoscopic surgery (NOTES) using flexible endoscopy has attracted attention as a minimally invasive surgical method that does not cause an operative wound on the body surface. However, minimizing the number of devices involved in endoscopic, compared to laparoscopic, surgeries has remained a challenge, causing endoscopic surgeries to gradually be phased out of use. If a flexible endoscopic full-thickness suturing device and a counter-traction device were developed to expand the surgical field for gastrointestinal-tract collapse, then endoscopic full-thickness resection using NOTES, which is seen as an extension of endoscopic submucosal dissection for full-thickness excision of tumors involving the gastrointestinal-tract wall, might become an extremely minimally invasive surgical method that could be used to resect only full-thickness lesions approached by the shortest distance via the mouth. It is expected that gastroenterological endoscopists will use this surgery if device development is advanced. This extremely minimally invasive surgery would have an immeasurable impact with regard to mitigating the burden on patients and reducing healthcare costs. Development of a new surgical method using a multipurpose flexible endoscope is therefore considered a socially urgent issue.

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Hepatectomia laparoscópica com portal único: experiência pioneira no Brasil

Abstract: Single port laparoscopic left lateral segmentectomy is feasible and can be safely performed in specialized centers by skilled laparoscopic surgeons.

Cited by 3 publications

References 14 publications

First Single-Port Laparoscopic Pancreatectomy in Brazil

First Single-Port Laparoscopic Pancreatectomy in Brazil

Single-port for laparoscopic gastric resection with a novel platform

Review of Pure Endoscopic Full-Thickness Resection of the Upper Gastrointestinal Tract

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